Sentinel lymph node biopsy in patients who had conversion of axillary lymph nodes from clinically positive to negative following neoadjuvant chemotherapy

2018 ◽  
Vol 92 ◽  
pp. S79
Author(s):  
S.H. Kang ◽  
M.H. Lee
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Lymph Node Biopsy ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Node Biopsy

Influence of Imaging Features and Technique on US-guided Tattoo Ink Marking of Axillary Lymph Nodes Removed at Sentinel Lymph Node Biopsy in Women With Breast Cancer

2021 ◽  
Vol 3 (5) ◽  
pp. 583-590
Author(s):  
Marlen Pajcini ◽  
Irene Wapnir ◽  
Jacqueline Tsai ◽  
Joanne Edquilang ◽  
Wendy DeMartini ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Nodes ◽  
Lymph Node Biopsy ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Node Biopsy ◽  
Initial Biopsy

Abstract Objective To describe tattoo ink marking of axillary lymph nodes (TIMAN) and the elements leading to successful removal at sentinel lymph node biopsy (SLNB). Methods An IRB-approved retrospective image review was conducted of breast cancer patients who underwent SLNB after TIMAN from February 2013 to August 2017, noting patient and tattooed lymph node (TLN) features, initial biopsy type, time to surgery, if the TLN was identified at surgery, and correlation with the SLN. Cases were divided into two groups: the presurgical group, which had primary surgery, and the pre-neoadjuvant chemotherapy (NACT) group, which underwent surgery after completing NACT. Results Of 30 patients who underwent 32 TIMAN procedures, 10 (33.3%) were presurgical and 20 (66.7%) were pre-NACT. The average lymph node (LN) depth from the skin was 1.6 cm, with an average of 0.3 mL of tattoo ink injected. Of 32 procedures, 29 (90.6%) had US images demonstrating the injection. Of these, 10 (34.5%) were injected in the LN cortex surface and 19 (65.5%) in the middle cortex. Seven (24.1%) were injected in the LN lateral aspect, 12 (41.4%) in the mid aspect, and 10 (34.5%) in the medial aspect. Of 32 LNs, 28 (87.5%) were tattooed immediately after initial biopsy and 4 (12.5%) at a later date. At SLNB, all 32 (100%) TLNs were identified, all correlated with the SLN, and 10 (31.3%) were positive for cancer. Conclusion Using an average of 0.3 mL of tattoo ink, all TLNs were successfully identified for removal at surgery, despite variability in LN and injection factors.

Predictors of positive axillary lymph nodes after sentinel lymph node biopsy in breast cancer

2001 ◽  
Vol 182 (4) ◽  
pp. 316-320 ◽  
Author(s):  
Shahab F Abdessalam ◽  
Emmanuel E Zervos ◽  
Manju Prasad ◽  
William B Farrar ◽  
Lisa D Yee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Nodes ◽  
Lymph Node Biopsy ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Node Biopsy

scholarly journals An AN OBSERVATIONAL STUDY OF SLN MAPPING IN PATIENTS OF LOCALLY ADVANCED BREAST CANCER FOLLOWING NCT

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Ankur Garg ◽  
Udbhav Kathpalia ◽  
Shweta Bansal ◽  
Manoj Andley ◽  
Sudipta Saha
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Locally Advanced ◽  
Lymph Node Biopsy ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Node Biopsy ◽  
Neo Adjuvant Chemotherapy

Background : Locally advanced breast carcinoma (LABC) includes a wide range of clinical scenarios- advanced primary tumors (T4), advanced nodal disease and inflammatory carcinomas(1). Traditionally, treatment of LABC included a combination of Chemotherapy, Radiation and Surgery(2). However, there has been a shift to Neoadjuvant Chemotherapy in recent times.(3) Histological status and the number of axillary lymph nodes with metastasis is one of the most important prognostic factors and most powerful predictor of recurrence and survival in patients of breast carcinoma and remains so, even after neo-adjuvant chemotherapy. (3) Information derived from the sentinel lymph node is considered valuable, with less discomfort to the patient when compared with axillary dissection.(4) However, its role in detecting nodal metastasis after neo-adjuvant chemotherapy in LABC is still debatable and definitive studies to evaluate its role are still evolving. (5) Materials and Methods: Patients of LABC were evaluated using ultrasonography (USG) of axilla. Neo-adjuvant chemotherapy (NACT) was administered and patients were reassessed by USG of axilla. Thirty patients with node negative axillary status were subjected to Sentinel lymph node mapping using isosulfan blue followed by Modified Radical Mastectomy and Axillary Lymph Node Dissection. Histopathological evaluation of stained and unstained lymph nodes done and the data, thus obtained, was statistically analysed.   Results: Sentinel lymph node biopsy performed using Isosulfan Blue dye alone, after neo-adjuvant chemotherapy predicts the status of axillary lymph nodes with low accuracy.   Conclusions: Further studies would be required to establish the role of sentinel lymph node biopsy in patients with LABC after NACT.

Sentinel lymphadenectomy for the staging of clinical axillary node-negative breast cancer before neoadjuvant chemotherapy

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11604-e11604
Author(s):  
J. Menard ◽  
J. Extra ◽  
J. Jacquemier ◽  
M. Buttarelli ◽  
E. Lambaudie ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Neoadjuvant Chemotherapy ◽  
Axillary Lymph Node Dissection ◽  
Axillary Lymph Node ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Node Biopsy

e11604 Background: Several authors reported sentinel lymph node biopsy after neoadjuvant chemotherapy. Nevertheless, the ideal time of sentinel lymph node biopsy is still a matter of debate. Methods: We evaluated the feasibility and the accuracy of sentinel lymph node biopsy before neoadjuvant chemotherapy using a combined procedure (blue dye and radio-labelled detection) in a homogeneous cohort study with clinically axillary node-negative breast cancer. Study candidates were patients referred to the Institut Paoli-Calmettes Cancer Center (Marseille, France) for the treatment of invasive breast cancer. Patients were included in the study if they had tumor more than 3 cm in diameter without palpable axillary lymph node for which a neoadjuvant chemotherapy was indicated in order to enhance the likelihood of breast conservation. An axillary lymph node dissection was performed after completion of neoadjuvant chemotherapy. Results: From September 2005 to September 2007, thirty-one women with T2 or T3 invasive breast cancer without palpable axillary lymph node underwent sentinel lymph node biopsy before neoadjuvant chemotherapy and an axillary lymph node dissection after neoadjuvant chemotherapy. Among the 20 women who had metastatic sentinel lymph node biopsy (65%), 4 (20%) had additional metastatic node on axillary lymph node dissection. By contrast, all the 11 women who had no metastatic sentinel lymph node biopsy had no involved nodes in the axillary lymph node dissection. The sentinel lymph node biopsy identification rate before neoadjuvant chemotherapy was 100% with any false negative. Conclusions: Sentinel lymph node biopsy before neoadjuvant chemotherapy is a feasible and an accurate diagnostic tool to predict the pre-therapeutic axilla status. These findings suggest that axillary lymph node dissection may be avoided in patients with a negative sentinel lymph node biopsy performed before neoadjuvant chemotherapy. No significant financial relationships to disclose.

SP8.1.7 Sentinel Lymph Node Biopsy or Neoadjuvant Chemotherapy- What comes first?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Smriti Karki ◽  
Yasmin Hassen ◽  
Arunmoy Chakravorty ◽  
Karolina Ajauskaite ◽  
Ekambaram Dinkara Babu
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Neoadjuvant Chemotherapy ◽  
Early Breast Cancer ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Nodal Disease ◽  
Node Biopsy

Abstract Aims NICE guidelines have not defined the timing of Sentinel Lymph Node Biopsy (SLNB) with respect to neoadjuvant chemotherapy (NACT). While there is an ongoing debate, the emerging consensus is in favour of SLNB following NACT in clinically node-negative (cN0) patients which confers the advantage of better prognostic outcomes as a negative SLNB negates further Axillary Lymph Node Dissection (ALND) and prevents patients having further unnecessary surgery. Thus, the aim of the study was to establish whether unnecessary ALND can be safely avoided by performing SLNB after NACT. Method Retrospective case records review of all patients treated with ALND at a single institution was undertaken from January 2018 to December 2019. Results 73 patients had ALND in this time frame. Patients received SLNB before NACT and ALND was performed if they were found node-positive on SLNB. Out of 73 patients, 24 patients had no further nodal disease, 26 had 1-2 macrometastasis and 23 had 3 or more macrometastasis on ALND. 57/73 patients had early breast cancer (T1/T2). 21/57 were cN0 but and 5/21 had NACT following SLNB and ALND after NACT. Of the 5 patients, 2 (40%) had no nodal disease on ALND. Conclusion 40% patients could have avoided ALND if SLNB was done after NACT. Also, 68% (50/73) patients who had ALND only had <2 lymph node macrometastasis. This data implies that patients with early breast cancer may be getting subjected to a second operation which not only is unnecessary but also may have debilitating complications.

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